“CAQH is committed to fostering a workplace of excellence where employees are encouraged to offer innovative ideas, make valuable contributions as individuals and support each other’s efforts,” said CAQH Executive Director Robin J. Thomashauer. “This recognition also underlines our commitment to a strong set of values and practices that enable us to attract and retain a stellar workforce.”

Full industry collaboration is required to develop an effective approach to collecting, maintaining and disseminating accurate, high-quality data from healthcare providers, according to a new white paper from the non-profit alliance CAQH. “Defining the Provider Data Dilemma: Challenges, Opportunities and Call for Industry Collaboration,” will inform the discussion when healthcare industry leaders gather in Washington on Sept. 29 at the 2016 Provider Data Summit, hosted by CAQH, to explore the topic.

The U.S. healthcare system is unnecessarily spending billions of dollars each year by continuing to use manual administrative processes for basic transactions, according to the 2015 CAQH Index® released today. Despite steady increases in the industry adoption of HIPAA electronic administrative transactions, the report emphasizes a remaining opportunity to save more than $8 billion each year.

Leader in Provider Data Enables 1.3 Million Providers to Use Self-Reported Information in CAQH ProView to Meet New Regulations

WASHINGTON, DC - 2/17/16

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The non-profit alliance CAQH today announced a new, fully-electronic solution to improve the quality of provider data in health plan directories. Launching as regulatory requirements increase for accurate provider directory information, DirectAssure™ is designed to help relieve the associated burden on healthcare providers.

The CAQH Committee on Operating Rules for Information Exchange (CORE®) today announced that it has awarded more than 200 CORE Certifications to health plans, hospitals and health systems, clearinghouses and vendors. Widely regarded as a must-have seal of approval across the healthcare industry, CORE Certification signifies that these organizations follow a set of HIPAA-mandated standards and operating rules for exchanging electronic administrative data.

The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today announced the approval of the Phase IV CAQH CORE Operating Rules package for four healthcare business transactions: healthcare claims; prior authorization; employee premium payment; and enrollment and disenrollment in a health plan.

U.S. healthcare could save $8 billion annually by transitioning six routine business transactions from manual to electronic, according to the newly published 2014 CAQH Index™. The CAQH Index tracks progress from manual (e.g., via phone, fax or mail) to industry standardized (HIPAA) electronic administrative transactions between health plans and healthcare providers. This annual report, the second from CAQH, details adoption rates and potential savings.

The CAQH® Committee on Operating Rules for Information Exchange (CORE®) today announced that healthcare organizations have voluntarily earned more than 150 CORE Certifications and many additional organizations have pledged to become CORE-certified. These commitments are a promising development in the drive to achieve interoperability through end-to-end adoption of healthcare operating rules.

CAQH® today announced that COB SmartTM has launched in all 50 states and the District of Columbia, enabling health plans and providers to identify overlapping insurance coverage nationwide. A CAQH SolutionTM, COB Smart determines when an individual is covered by more than one insurer and also indicates which insurer should pay first. The solution streamlines coordination of benefits (COB) activities so that healthcare claims can be processed correctly the first time.